Multimorbidity patterns in the elderly and their association with health care utilization / 中华老年医学杂志

ABSTRACT

Objective:To identify multimorbidity patterns in a nationally representative sample of elderly patients with chronic diseases and to explore the relationship between these multimorbidity patterns and health care utilization.Methods:Based on data from the China Health and Retirement Longitudinal Study(CHARLS)in 2018, 10 764 elderly people aged 60 years and older were included, and latent class analysis(LCA)was used to identify multimorbidity patterns in the elderly, and the Logistic model was used to analyze the relationship between multimorbidity patterns and healthcare utilization in 8 041 elderly people with complete information on the variables.Results:The primary LCA identified five categories, with 4 164(52.1%)participants belonging to the relatively healthy category.The other four categories represented different patterns of multimorbidity, with 473(5.7%)belonging to the respiratory disease category, 1994(25.3%)to the vascular disease category, 948(11.7%)to the stomach-arthritis/rheumatism disease category and 426(5.2%)to the multisystemic disease category.In terms of outpatient service utilization, compared with the relatively healthy category, the multisystemic disease category was the most likely one to seek outpatient services( aOR=2.920, 95% CI: 2.305-3.699), followed by the respiratory disease category( aOR=1.827, 95% CI: 1.429-2.336), the stomach-arthritis/rheumatism disease category( aOR=1.680, 95% CI: 1.392-2.027), and the vascular disease category( aOR=1.482, 95% CI: 1.267-1.734).In terms of inpatient service utilization, compared to the relatively healthy category, the multisystemic disease category was the most likely one to seek inpatient services( aOR=2.718, 95% CI: 2.158-3.425), followed by the respiratory disease category( aOR=2.627, 95% CI: 2.105-3.280), the stomach-arthritic/rheumatism disease category( aOR=1.940, 95% CI: 1.624-2.318), and the vascular disease group( aOR=1.887, 95% CI: 1.632-2.183). Conclusions:There is a significant correlation between multimorbidity patterns and outpatient and inpatient service utilization in the elderly.Compared to relatively healthy people, those with one of the other four multimorbidity patterns have a significantly increased risk needing outpatient and inpatient services.